A Small Bowel Capsule Endoscopy is a procedure which involves ingesting a small Pill Cam SB capsule (the size of a large vitamin) which will pass naturally through your digestive system while taking pictures of the intestine. The images are transmitted to the Senor Array which is placed on your abdomen. The Sensor Array is attached to a walkman-like Data recorder which saves all the images. It is located in the Recorder Belt which is worn around your waist. After 8 hours, you will return to the facility removal of the Recorder Belt. The Pill Cam SB capsule is disposable and it will be excreted naturally in your bowel movement. In the rare case that it will not be excreted naturally, it will need to be removed endoscopically or surgically. In order for your Physician to get the most accurate information for this examination, you will need to follow the instructions below:
Registration for the procedure:
Take the “SB Capsule Endoscopy Request Form” with you to the hospital.
Do not eat or drink anything the night prior to the procedure (except your usual medications).
Do not take any iron products for 5 days prior to the test.
If you are a diabetic, please hold diabetic medications on the morning of the procedure until the procedure is completed.
Abstain from smoking 24 hours prior to the SB capsule Endoscopy.
Male Patients should shave their abdomen 6 inches above and below the navel on the day of the examination.
Start the day prior to the procedure
· Regular Breakfast
· Clear liquids only for lunch and supper
· 4:00 4 Ducolax tablets with 32oz of Gatorade (not red)
· 6:00 238 grams of Miralax with 32oz of Gatorade (not red)
Drink 8 oz every 15 minutes until solution is gone.
· 8:00 Drink additional 32 oz of clear liquid.
· PLEASE avoid high fiber foods such as all green leafy vegetables, dried beans, and corn 2-3 days prior to procedure.
· No medications the morning of your procedure.
· Nothing to drink after 10pm
***No Fibers 3 days before or the morning of the procedure.***
Clear Liquid List No red or purple based drinks
You can have:
Apple Juice White Grape Juice Mountain Dew Lemonade
Ginger Ale Sun-drop Mellow –Yellow Gatorade
Kool Aid Sprite Tea 7-up
Warm clear broth (chicken or beef) Coffee (No creamer or milk)
Day of the SB capsule Endoscopy
· Arrive at the hospital at your scheduled time for your SB capsule Endoscopy dressed in loose fitting 2 piece clothing.
· At the hospital you will have a pre-procedure interview. During this interview you should be informed that SB capsule Endoscopy is associated with a small chance of intestinal obstruction. You will be checked-in and asked to give your informed consent.
· The sensor Array will be applied to your abdomen with adhesive pads and will be connected to the Data recorder which you will wear around your waist. After that you will be instructed to ingest the Pill cam SB capsule.
After ingesting in Pill cam SB capsule
· After ingesting the Pill cam SB capsule, do not eat or drink for at least 2 hours. After 4 hours you may have a light snack. After the examination is completed, you may return to your normal diet. The above instructions related to eating apply unless your Physician specifies otherwise. Contact your Physicians immediately if you suffer from any abdominal pain, nausea or vomiting during SB capsule Endoscopy.
· After ingesting the Pill cam SB capsule Endoscopy and until it is excreted you should not be near any source of powerful electromagnetic fields such as one created near an MRI device or amateur (ham) radio.
· Occasionally, some images may be lost due to radio interference. On rare occasions this may result in the need to repeat the SB small capsule Endoscopy examination. In this case, the Physician will advise you to stay within the premises of the clinic during the SB capsule Endoscopy to prevent this problem from recurring.
· SB capsule Endoscopy lasts approximately 8 hours and is considered complete according to your Physicians instructions. Do not disconnect the equipment or remove the belt at any time during this period. Since the Data Recorder is actually a small computer, it should be treated with utmost care and protection. Avoid sudden movement and banging of the Data Recorder.
· During the SB capsule Endoscopy, you will need to verify every 15 minutes that the small light on top and the Data Recorder are blinking twice per second. If for some reason it stops blinking at this rate, record the time and contact your Physician. You should also record the time and nature of any event as eating and drinking, your activity and unusual sensations. Return the Event Form with these notes to your Physician at the time you return the equipment.
· Avoid any strenuous physical activity especially if it involves sweating and do not bend over or stoop during the capsule Endoscopy.
After completing SB Capsule Endoscopy
· You will be instructed by your Physician on how to return the equipment at the end of the SB capsule Endoscopy. If you were instructed to remove the equipment by yourself, do the following:
* Disconnect the Sensor Array from the Data Recorder
*Take off the recorder belt
*Disconnect the battery pack from the Data Recorder
*Place the Data Recorder and Battery pack in a safe place
* To remove the Sensor Array from your abdomen, do not pull the leads of the Sensor Array! Peel off each adhesive starting with the non-adhesive tab without removing the sensor from the adhesive sleeve. Place the Sensor Array with the rest of the equipment. The attending Physician will use the data from the examination for the medical evaluation.
· The Data Recorder stores the images of your examination. Handle the Data Recorder, Recorder Belt, Sensor Array and Battery Pack carefully. Do not expose them to shock, vibration, or direct sunlight, which may result in the loss of information. Return all equipment to the hospital as soon as possible.
· If you do not positively verify the excretion of the Pill Cam SB capsule from your body, and you develop unexplained post procedure nausea, abdominal pain, or vomiting, contact your Physician for evaluation as and possible X-ray examination.
· Undergoing an MRI while the capsule is inside your body may result in serious damage to your intestinal tract or abdominal cavity. If you do positively verify the excretion of the Pill Cam SB capsule from your body you should contact your Physician for evaluation as and possible abdominal X-ray before undergoing an MRI examination.
Date of procedure: ________________________
Arrival Time: _________________________